Cornell Creative Writing - May 2008
(Do not use ENTER key until ready to submit form)

Name   
           EXACTLY as it appears on passport

Nationality     Passport Number

School Address    City/State/Zip   

Home Address    City/State/Zip

Home Phone    School Phone    Cell Phone                    

Email Address

Frequent Flyer Information

Continental  Northwest   Delta    

Special Meal/Dietary Requirements

Salt Free            Kosher            Vegetarian           Other

If you need any type of deviation from the scheduled flights, please contact
me directly by phone or e-mail to discuss.

All Flights Are Non-Smoking

Please Mail Check to:
Baker Travel, Inc.
320 S. Geneva St.
Ithaca, New York  14850
ATTN:  Mary Ann Covert